Is It Safe?

Is it Safe?

Osteopathy Shown to be one of best treatments for back pain

MRC FINDS THAT ADDING SPINAL MANIPULATION AND EXERCISE TO GP CARE PROVIDES RELIEF FOR BACK PAIN

A Medical Research Council (MRC) trial to assess ‘best care’ in general practice for patients with lower back pain has found that spinal manipulation, as practised by osteopaths, followed by a programme of exercise, provides significant relief of symptoms and improvements in general health. The results of the trial are published online early 2006 in the British Medical Journal.

Back pain is one of the most common ailments confronting general practitioners (GPs), affecting 80% of the population in the UK and costing the nation £6 million a year in lost working days and health care.

The UK Back pain Exercise And Manipulation (UK BEAM) trial is the first of its kind to examine the effectiveness of two treatments – spinal manipulation and exercise – alone and in combination, for the routine management of low back pain in primary care. The national trial also compared outcomes between participants receiving manipulation in NHS premises and private premises.

Commenting on the outcomes of the study, Ian Russell, Professor of Public Health & Director of the Institute of Medical and Social Care Research at the University of Wales Bangor, and a lead researcher in the trial team said:

“Though the average benefit to patients was only moderate in size, back pain is so widespread and so costly to society that these benefits add up to substantial economic benefits across the UK. Our analysis also showed that the cost to the NHS was modest. Added to GP ‘best care’, spinal manipulation gives the best value for money.”

The General Osteopathic Council (GOsC) welcomed the findings of the UK BEAM Trial, its contribution to the management of back pain within the UK and internationally, and its potential influence on both practice and health care commissioning.

The National Council for Osteopathic Research (NCOR) today was encouraged by the positive effects which the spinal manipulation and exercise treatment package had on a patient group that continues to grow in size.

“The immense cost to society and to the individual that back pain can inflict is well documented; it is encouraging to identify an adjunct to GP care that is both beneficial to the patient and modest in terms of economic outlay. The reasons behind the positive effect of spinal manipulation and exercise treatment had on the general health of the trial participants merits further research in itself,” commented Carol Fawkes, Research Development Officer at NCOR.

“The research focus of the osteopathic profession is concerned with examining the practice, building an evidence base for osteopathic treatment and seeking ways in which that treatment can be enhanced for the greater benefit of the patients who consult osteopaths in growing numbers.”

Research Shows how to best treat Bad Backs

Spinal manipulation is key to curing back pain

Researchers say they have found the most effective treatment for people suffering from a bad back.

The Medical Research Council team said chiropractic, osteopathy or manipulative physiotherapy – plus an exercise programme was most effective.

Writing in the British Medical Journal, they say this three-pronged approach provides significant symptom relief.

They hope their findings will clarify how to treat back pain – one of the most common conditions seen by GPs.

More than 1,300 patients whose back pain had not improved through the “first line” advice of keeping active and not taking bed rest.

They filled in questionnaires on their general health, back pain, beliefs and psychological well-being before being randomly assigned to a treatment. Further questionnaires were completed after one, three and 12 months.

Cost effective

Patients were allocated a class-based physical exercise programme overseen by a physiotherapist, one form of spinal manipulation (such as physio), or a combination of the two.

People in all groups saw some improvement in their back function.

Those assigned to exercise classes in addition to GP care reported a small benefit at three months but not at one year.

Spinal manipulation plus GP care was linked to a small to moderate benefit at three months and a small, on average, benefit at one year.

But the biggest improvement was seen in those patients assigned to combined manipulation and exercise in addition to GP care.

They reported a moderate, on average, improvement at three months and a smaller average improvement at one year.

The researchers also examined the cost of the treatments and found both spinal manipulation and the combined package of spinal manipulation and exercise achieved similar benefits to patients at around the same cost to the NHS.

Martin Underwood, Professor of General Practice at Queen Mary, University of London, who worked on the study, said: “One of the commonest health problems I’m asked to treat as a GP is back pain.

“This trial has shown that physical treatments – a combined package of spinal manipulation and exercise in particular – may offer relief to the large numbers of patients whose back pain persists after they’ve received best care from their GP.”

Professor Ian Russell, Director of the Institute of Medical and Social Care Research at the University of Wales Bangor, another member of the research team, said: “Though the average benefit to patients was only moderate in size, back pain is so widespread and so costly to society that these benefits add up to substantial economic benefits across the UK.

“Our analysis also showed that the cost to the NHS was modest.

“Added to GP ‘best care’, spinal manipulation gives the best value for money.”